Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.99 / $175.23 / $596.38	Facility		$35.99	$175.23	$596.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.35 / $15.57 / $82.80	Facility	26	$8.35	$15.57	$82.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.99 / $175.23 / $626.72	Facility	TC	$35.99	$175.23	$626.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.46 / $45.19 / $124.22	Professional		$22.46	$45.19	$124.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $9.34 / $42.45	Professional	26	$7.00	$9.34	$42.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.78 / $110.53 / $172.50	Professional	50	$63.78	$110.53	$172.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.21 / $15.04 / $17.94	Professional	52	$11.21	$15.04	$17.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $29.44 / $88.62	Professional	TC	$21.32	$29.44	$88.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.95 / $29.65 / $37.29	Professional		$20.95	$29.65	$37.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $7.67 / $11.38	Professional	26	$6.11	$7.67	$11.38
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.77 / $48.35 / $55.95	Professional	50	$37.77	$48.35	$55.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.42 / $19.64 / $30.70	Professional	TC	$18.42	$19.64	$30.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.78 / $70.61 / $117.66	Facility		$19.78	$70.61	$117.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $29.72 / $37.15	Professional		$26.01	$29.72	$37.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $6.37 / $8.96	Professional	26	$5.57	$6.37	$8.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.43 / $23.35 / $29.19	Professional	TC	$20.43	$23.35	$29.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.23 / $189.46 / $247.64	Facility		$65.23	$189.46	$247.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $37.72 / $64.45	Professional		$27.10	$37.72	$64.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $9.97 / $17.27	Professional	26	$6.81	$9.97	$17.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.56 / $40.56 / $40.56	Professional	50	$40.56	$40.56	$40.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $27.35 / $47.19	Professional	TC	$19.69	$27.35	$47.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.94 / $40.29 / $276.18	Facility		$31.94	$40.29	$276.18
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	TC	$118.08	$118.08	$118.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $33.20 / $221.82	Professional		$29.00	$33.20	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.85 / $71.00	Professional	26	$8.13	$8.85	$71.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $25.03 / $170.86	Professional	TC	$20.65	$25.03	$170.86
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $195.48	Facility		$80.90	$80.90	$195.48
United Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $33.20 / $53.12	Professional		$29.00	$33.20	$53.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $8.66 / $15.60	Professional	26	$7.92	$8.66	$15.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $24.54 / $40.15	Professional	TC	$20.41	$24.54	$40.15